Lost It, Again

I lost it in the office at the psych's. Completely, utterly broke down. Shaking, sobbing. I think I used half his tissue box. I couldn't stop. And he just sat there and let me cry, which made me feel stupid and dumb and broken. I admitted I hadn't been med compliant and that I couldn't keep up with the hydration on the Lithium to offset the side effects. And when he suggested Abilify, I had to shoot that down because I'd been on it and gained 50lbs. And that's when my last psychiatrist suggested bariatric surgery rather than meds. What the fuck?

So I'm out in the parking lot outside the office, calling Jb, because I suddenly realize what day it is and that he's not getting paid 'til next Friday, and I blew all our foodstamps on food for, like, 4-5 days and a bunch of crap, and we've a whole other week we need groceries for. So I fucked up. And I'm bawling on the phone to him about that. And I can't stop. I can't stop crying. Up and down, up and down, up and down. Fucking roller coaster, and I want off. But no, the psych says, "That seems to be symptomatic of your illness." So it's official: I'm a rapid cycler.

Anway, prescription changes: off the Lithium. Still on the Lamictal and Klonopin. Wellbutrin is now gone. Zoloft has been up from 50 to 100MG.

They're Back

Psych took me from 600 Lithium to 300 because I was showing side effects. And while Lithium at 600 seemed to stabilize my mood, it stabilized it at a moderate depression. The 300 Lithium, however, doesn't stabilize me. I've had one 3-4 day period of hypo/mania, and I crashed afterward into a moderate depression. This is hell on my relationship with Jb. It's hard to feel close--for him, as well, I imagine. I don't know how to get closer to him when I feel like this. I feel so self-centered and day-to-day. The financial situation doesn't help. We argue over spending $5. That's how bad things have become. And the IBS just gets worse and worse.

Med Update

Therapist is going to help me fill out my SSDI form. My psychiatrist is behind this as well, which helps having the two behind you.

As for meds, psych is dropping me down to 300MG Lithium. I was showing side effects: shaking hands, disoriented, walking like a sailor. He suggested I hydrate more.

In Passing

So, it's passing. I think. I hope. That was probably the worst I've been since the hospital. Jb and I have a rule: no killing myself. Wednesday, it was a hard rule to keep. Thursday and Friday, I just wanted for him to come home. Smoked a lot. Rocked myself on the porch stairs trying not to think about it while I've got Leonard Cohen's "Everybody Knows" playing through my head like that last strip of film that keeps slapping against the reel--over, and over, and over.

I should have gone to the hospital Wednesday. I should have gone Thursday. I was that bad. But I couldn't stand the idea of another stay, starting back at square one. It had taken me 5-6 months to pull myself out of the last one, and since the first hospital stay, I swear it's as if I get worse and worse, and never better. Or there's the hope of better, and then the crash hits. I'm always waiting for the other shoe to drop. But mostly, I couldn't put Jb through the strain of another hospital stay.

This weekend I have Jb as a babysitter. I've an appointment Monday with my therapist. Another Wednesday with my psych. It'll give me things to do, keep me in line.

Out of the blue, a woman I'd struck up a friendship in the ward called me. Last time I'd talked to her, she'd been convinced she was going off her meds and talking about suicide. I couldn't call her after that; I didn't want to know. I couldn't deal if she had. It was so good to hear her voicemail, to know she wasn't a fallen comrade, that I cried. When I called her back, I was suicidal, and she was completely manic. I couldn't keep up with her, as slow and dumb as my brain had gotten. But then again, how do you keep up with someone on a manic kick?

20/20 Hindsight

It wasn't until I was in the truck with Jb on the way back from the store when I realized that I went into the psychiatrist's office hoping for a different diagnosis. Something simpler. Not bipolar. It made me tear up.

New Psych, New Evaluation, Same Diagnosis

I love the new psych. I am not going back to the old one. The new one spent an actual hour and a half with me, listening to me, to my history, to my ideas about my meds. I was prepared this time. In all fairness to my last psych, he got me straight from the hospital, and all I could do for several visits was sit in the chair and cry. But this time, I used my resume to help create a timeline of episodes of depression and hypomania and brought along a list of my meds and when I was given them.

On first blush, the psych agrees that I have some form of bipolar. Probably bipolar II because I don't seem to show a history of full blow mania or psychosis. He's shoving Remeron off my list of meds, which I'd tried to talk my last psych into doing because I knew it wasn't working for me. And while my new psych thinks Lamictal is good for some types of bipolar, he thinks Lithium might be the better choice for me, but we need some baseline blood tests. I go to my new PCP Monday, and my psych gave me a "prescription" for what he required in the blood test.

He also wants my past history from the hospital, from my last psych, and from my last PCP. He's the first psych to be so thorough. And I could tell he listened to me. He agreed with me when I said that I thought they were merely throwing drugs at me and couldn't understand why I was on three -- count them: three -- anti-depressents. He'd like to have me try Lithium and get me down to one anti-depressent or maybe a muscle relaxant? That last bit I'm not sure of. I need to research that more in the treatment of bipolar disorder.

It was a second opinion, though, and he seemed utterly professional and interested in my input -- that I wanted an evaluation and a diagnosis. When I walked out the door, I told him how glad I was to have found him and that he seemed very professional and gave me a better evaluation than I've had since the hospital. He kinda smiled, like he was feeling a little self-conscious, and told me I was a very good patient. So I'm encourage. He seems like someone who's willing to work together on my diagnosis, and that matters a great deal to me.

I really lucked into this non-profit organization. They are, without equal, the best treatment I've received since being in Maryland. I even called the head honcho of the place to let him know how happy I was with my therapist and the meeting with my psychiatrist. After some shoddy treatment, you don't realize what a relief it is to finally find the holy grail of psychological specialists. And we often overlook people who do their jobs, and do them well. I wanted to be sure the head honcho knew what a great set of people he had.

New Psych

Tomorrow's my appointment with a new psychiatrist. I haven't given up my old one, entirely. I'm considering her a fall back option. But this new psychiatrist works with the same agency as my therapist, and as I like her a great deal and the agency seems extremely professional, I want to give this guy a real shot. My therapist and I have been discussing my diagnosis, and I've explained to her the whirlwind way they slapped a label on me in the hospital, then again at my last psych without any sort of true evaluation or tests, etc. My therapist said she was going to talk to the psych before my appointment, let him know what we'd been discussing. I told her if she should stress anything it's that I would really like to have a thorough evaluation, including tests if available and that's what it takes, and a real diagnosis. I need something solid to hang my hat on.

Here's hoping.

Silence

My old professor always said that even silence was a form of rhetoric. And if my silence here says anything, it says that I've been busy, that I've felt more stable, that I've been taking my meds, seeing my psych, and seeing my therapist.

In fact, my therapist, and the non-profit she works for, seems so much more professional than my psych that I've gotten her to hook me up with a psych appointment there. I told her that the hospital was so shoddy, that I never see my psych, only his nurse practitioner, and that no one's ever sat me down for a real evaluation, and I told her I want that: I want a real evaluation and diagnosis. And she thinks that's a good step in the right direction. So many things mimic aspects of bipolar, and I don't want to be on five meds if they're the wrong meds for the wrong diagnosis.

We did broach a few subjects that I don't tell many people. Like when I'm elated, the leaves glow. Or that when I'm quiet, it's like I can drop in and listen to this party line in my head. That people are having distinguishable conversations. And that I've seen a shadow figure of a man twice at this apartment and that I used to see the shadow figure of a man and a small dog all the time when I was a little kid. We talked about Jungian psychology and getting more into that.

Psych Check-In

I haven't felt like writing here much. I had a good bout of depression going last week. Slept until 2:30 one day, got up for a few, then went back to sleep until Jb came home. Couple fights put me so low that I was thinking about the hospital and suicide again. It passed, though, which is good. I did make up an excuse to not see my therapist last Friday. Jb'll have a fit when he reads this, as I told him I was sick, which I was, just not in a way he could understand. Or so I felt.

There's other little things. I haven't cooked in a week or so. Haven't made a grocery list yet for this two weeks. Haven't done dishes in a week. Let the apartment go to hell. Jb helped me clean up this weekend (i.e. Jb mostly cleaned up. I've yet to do the dishes). On a side note, I did apply for unemployment today, and we'll see how that goes given the obnoxiously ridiculous situation that was my work's request for a voluntary resignation and then an unpaid LOA without any documentation whatsoever. I finally just quit, and I'll probably have to explain that.

Did see the psych, or rather, the nurse practitioner, who I like better anyway. She still considers me unstable and has put me on yet another medication, Zoloft. So that's what? Five psych drugs. You've got to be kidding me. I'm really unhappy with this. I'm almost to the point where I'm ready to throw up my hands, throw out all the fucking meds, and just try to work through things with this therapist, who I'm liking quite a bit. I mean, seriously, five fucking meds:

Remeron 30 MG 1x a day (Sedative/Anti-depressant)
Lamictal 150 MG 2x a day (300 MG total) (Mood Stabilizer)
Klonopin 1MG 3x a day (Anti-Anxiety)
Wellbutrin XL 300 MG 1x a day (Anti-depressant)
Zoloft 50 MG 1x a day (Anti-depressant)

Plus the Benicar, the Levsin, and the Protonix that I'm always on for hypertension and IBS. I honestly need a pill organizer at this point. A quarter of the time, I forget to take my meds. Maybe not so much. But I'm not daily compliant. I don't remember until too late in the morning, or I totally forget at night. Maybe an organizer would help. I don't know.

Feeling increasingly frustrated.

Crazy-Ass Welcoming Committee

This blog is not entirely solopsistic, though it might seem so. But truly -- beyond wanting to bash my head into a wall -- I am putting this down for posterity. Because no one invites you into the Bipolar, unemployed, uninsured, disability club. And frankly, someone should. There should be a full-blown, crazy-ass welcoming committee. And in it, there should be information on FMLA, the American Disabilities Act, the EEOC, and your local Department of Health and Human Resources. Because you will never see Oprah touting the latest diet craze: The Poverty Diet.

Department of Health and Human Resources: Your state has one. It is like the DMV. No one will explain anything to you. Checkmark anything that might give you money. They would be very happy not to give you any resources at all. They are helpful like that.

SSDI/SSI: Whether you are truly disabled or not, you will not get this. If you even apply for disability insurance (i.e. the government's money), they will reject you off-hand, and if you truly want to be stubborn, you need a lawyer and copious notes of dates and days before the government will let you pry any money at all from their cold, dead hands.

Hospitalization: There are good and bad mental wards. Your PCP probably knows something about this, as might your therapist or psychiatrist. Ask. All mental wards are not the same, but they are a little like prison. Keep juice boxes and fruit to trade for other useful items.

Food Stamps: Do not be fooled by the rhetoric. If you want your SO to be able to use the card, he can. No one checks who it belongs to. Do not, however, put their name on your application for food stamps unless you are married. If you do, you will not receive enough money to feed a gerbil.

The Poverty Diet: When the DHHR determines that, though you've been fired and have no money of your own, you aren't eligible for emergency food stamps, become religious. Religious charities are the number one place to receive donated food. Humbling, yes, but your stomach ain't rumbling.

Temporary Disability Assistance: There is such a thing, but you aren't supposed to know. This is why you check every box when you are in the DHHR. This can be hidden under something called Temporary Cash Assistance. Do not be fooled.

FMLA: Yes, you can take nearly 12 weeks of leave under the Family Medical Leave Act. Your employer, however, will not like you, and most likely, they will find another reason to fire you -- if they don't force you into a voluntary resignation.

EEOC: You will spend half your day waiting for the three appointments they have available that day. In your appointment, they will listen very kindly, then tell you they cannot help you -- unless you wish to make your employer conform to the American with Disabilities Act.

ADA: The American with Disabilities Act does, indeed, protect your right to certain accommodations within reason. Your employer, however, has a much different definition of "within reason" than you do.

Unemployment: If your doctor has signed a paper telling the State that you are unable to work for a year and if you receive temporary disability from the state, you cannot get unemployment. Unemployment is only for people able and willing to work (i.e. though the body may be willing, the mind is not; your mileage may vary).

Medical Assistance: You can apply for this, too, from your local DHHR. While you're virtually guaranteed some sort of declaration about your food stamps and temporary disability within 30 days, medical assistance is a totally different beast. The medical assistance board is always backed up, and apparently, no one has -- or will divulge -- their phone number. You will rot for three months or more before you hear anything about this. Once you do, you'll understand why it's worth the wait.

Medicaid: Your medical assistance has been approved. If you're lucky, you get a nice shiny packet explaining things. If you're not so lucky, you get a phone call telling you that you have two days to find a Managed Care Organization and a PCP. However, once this is achieved, you will realize that when politicians talk about the Health Care Crisis, they are not talking about Medicaid. Medicaid is what it must be like to live in Canada. Your prescriptions are $1, your visits to your psych, therapist, dentist, and doctor are free. As are a host of other disasters.

Bankruptcy: It happens. You can't get unemployment, the state barely pays you enough to eat, and it could be months before you get medical assistance. In the meantime, you are accruing debt and medical bills as if you can afford to. Call your Credit Counseling Service. Then call your local Legal Aid office. They will waive all fees for their assistance. Go figure.

Psychiatrists/Therapists: Believe it or not, the title does not always fit the figure. Psychiatrists and therapists, the ones with the shiny credentials, may suck wombats. Most nurse practitioners and licensed social workers are far more caring. It can leave you dumbfounded when they actually listen to you.

Seriously, these are all things I wish someone would have told me. I learned it all the hard way, and not everyone wants to self-educate. These tidbits are valid, however, and have been learned through harsh real life experience or from other patients in the mental ward.

Psych Check-In

Haven't been sleeping well. Unable to fall asleep, so up until 3am, etc. Wake up feeling like I have a hangover. Using caffeine to get me functioning after being off caffeine for so long. All things I tried to convey to my psych today. She still considers me unstable, which is frustrating, and yet, true, and while she doesn't think I'm stable enough to consider a part-time job, she thinks some volunteer work would be good for socialization at this point. Happy to hear I have a therapist appointment tomorrow, as well.

My change in meds:

Benicar 45/100 -- 1x a day (Same)
Klonopin 1mg -- 3x a day (Upped)
Lamictal 150mg -- 2x a day (Upped)
Remeron 30mg -- 1x a day (Same)
Wellbutrin 300mg -- 1x a day (Same)

Since I'm having trouble sleeping, she's given me some leeway to mix my drugs around (i.e. taking Lamictal all at night or all in the morning, taking half a Klonopin in the morning if I'm groggy, etc.) The problem with the Klonopin is that it has a 12-hour half life, so if I take it all at night to help me sleep, how does it help my anxiety during the day?

I'd also be curious if anyone else experiences episodes of hypomania or anxiety that seem to be directly set off by doctor visits. I always seem worse when I go.

Oh, we also discussed my driving. I haven't been driving in a year or two. Jb's basically been using the car and what not. Lately, he's been encouraging me to try to get behind the wheel again, but it's causing me such anxiety that I don't think I'm ready for it. More importantly, my meds keep me off-balance, dizzy. The psych agreed that with my meds I probably shouldn't be driving until I'm more stable.

On a side note: The nation's health care system may suck, but state insurance for the needy, such as Medicaid, is a godsend. All of my prescriptions cost me $4. Free psych and therapist visits. Free doctor visits and lab tests. That's such a financial relief right now when I can't be working.

On That Note

I feel pretty good today, though I forgot to take my meds last night, and I haven't taken them yet this morning. There's a false sense of not needing them in that, I know. Because I feel fine. But that's probably because they're still in my bloodstream. The half-life of most drugs isn't short enough for one missed dose, or even two, to end in the drug completely leaving your system. But I will take my meds, I will try to make a cake I've been determined to make for weeks, and I'm going to try to mop, and maybe vacuum, while I have the energy and motivation.

N.B. This is when I wonder why I need to go in to see the psychiatrist or the therapist, now that I have one. I'm afraid I'll have nothing to tell them. That it'll be a waste of time. That I'll be fine, and no one will believe me about how I did feel, have felt. It causes me genuine anxiety.

Morning Check-In

Sleep: Up since 8:30ish. Not so bad. Had Jb still been around this morning, I'd have begged him to take a day off. Don't want to be alone today. Slept fairly well last night, though, I think.

Dream: Had a dream about my ex-husband. How we were both dating now, how we'd both changed, seen the changes in each other, and wondered if those changes would have made a difference when we were still together. Sure that they would have. But that all passed us by.

Cigarettes: Still smoking. Probably a good 4-6 yesterday. It's good I bum off Jb so they're not around during the day, though I could use some later when I go to the DHHS.

Weight: Don't want to look. No need to ruin an already stressful day. Besides, we ordered in last night and I had a P'zone, so that can't be good.

Meds: Compliant. Took them last night and this morning.

Food: Protein Boost Special K (the psych says I need protein) with a little milk and an apple.

Mood: Enh. I'm here. Like I said, this morning I was a little grasping, would have wanted Jb to stay home, which he wouldn't have and couldn't have. I'm intensely lonely and isolated right now due to the unemployment. It's made me needy and restless. Think it might be time to find that part-time job when I get my stimulus check and can afford a new blouse to interview in.

To Do: Should call HealthChoice and see if they sent my insurance package yet. Need to reschedule psych appointment. Need to schedule a PCP appointment for blood work. Need to find a therapist, which means making some calls.

The Bad Part of My Day: Have an appointment at 4:30pm at the Department of Health and Human Services to review my need for food stamps and temporary cash assistant/temporary disability assistance. Both rather important things that are helping us get by right now. So, of course, the stress about this started last night.

Relationship: Jb and I are snapping at each other a great deal. I'm ugly and mean a great deal of the time, irritated by everything and hateful. It shows in contempt and so many other ways that I feel like if I can't control this, get even somehow, I'm going to ruin everything. I used to treat my ex this way, and it's little wonder he never wanted much to do with me. He was always happy to go his own way. I'm sure, toward the end, he never felt loved. How could he?

I miss friendship, though. Not the constant caretaking of a relationship, but the ease of a friendship where you're allowed to be who you are without having to worry about stepping on someone's overly sensitive feelings. Everything becomes internalized in relationships, when I'd really rather just have someone to listen and say, "Yeah, that really sucks, you know?" And affection, an arm around the shoulder, a hand at the small of my back, some actual caretaking, the kind you get from a parent if you have good ones: a shoulder rub, a smoothing back of your hair, a body to curl up into and hug, a sense of safety and being loved. I get tired of paying bills, doing dishes, doing the grocery list, cooking, doing this or that, being responsible for this or that. I feel like I'm only good for the things I do in this relationship, and I'm tired of taking all the responsibility for these things. It's too much, and I resent it.

Lost It

Completely flipped the fuck out at the psych's. Anxious all the way there, pacing the office while I waited, he'd barely sat down when I started trying to talk to him about work. Couldn't sit for my nerves, just kept walking back and forth, and goddammit if I didn't start crying. Told him about how my job had forced me out, the deal of unpaid leave for insurance, the lack of a determination from the county, everything, and his reply? Why didn't I take the voluntary resignation, go on unemployment and take Cobra. And I had no reply for that, except that Cobra's expensive. But now I don't know. Maybe that's exactly what I should do. The situation couldn't be worse than the one I'm in now, and even after paying for Cobra, I couldn't be bringing in less than the county's giving me. So why the fuck not? I plan to look into it.

But what truly pisses me off is that that was my appointment. How's the Klonopin? Sometimes it's enough, sometimes it isn't. I don't go out unless I'm with my boyfriend. It's too hard. Do you have enough Lamictal? No, I'll run out this week. Do you have any samples? No, Lamictal's going generic, so they're not handing out any samples anymore. (Then it doesn't matter because I can't fill this prescription until I have the money anyway.) Are you seeing a therapist? I'm on the waiting list for one. Why? Because they're sliding scale. You're making an appointment for one when you go out front. Do you need to see someone today? No, don't worry about it. I always worry about it. You're seeing Nicole in one week and making a therapy appointment.

And out the door. What the hell did that do for me? I'm hustled off to his psychiatric nurse practioner for prescriptions and off to his wife therapist for her 15m of infinite wisdom: "Take a 10m walk, take one thing at a time . . . " Because, you know, I'm not a fucking moron who hasn't had successful and useful cognitive-behavioral therapy before. I've a Master's degree for Christ's sake. I'm not an idiot. I think it's time to take things into my own hands, to shut the hell up, dust myself off, and get out there and do what needs to be done. No more cowering. No more safety net. No more allowing myself to be weak. I need to muscle through. No excuses. If I'd done that, I would have never ended up in the hospital or lost my job.

And to top off my day? My fucking computer won't boot. I'm so screwed.

Everybody's Comin' to Get Me

Last night, paranoia hit me hard. It's been hitting me on and off for a long while, though it gets stronger and weaker at times. But it's only last night that I think I started seeing it for what it is. Half the time it manifests itself in the usual ways: thinking people are always watching me, talking about me behind my back, thinking mean thoughts about me, conspiring about me at work. Now I'm starting to think it manifests itself heavily in my relationships. I start thinking things about my significant other like, "Oh, he doesn't really love me. I just want him to admit what I already know: he doesn't actually love me." And there's paranoia about what they're doing, thinking, mostly in regards to me or how it affects me. Are they cheating? Would they ever? Do they want to? What are they hiding on their computers? What are they hiding in their lives? Why don't they ever want to spend time with me? The computer/tv/object must be more important than I am. Maybe I'm not capable of being loved. Etc., etc.

My thoughts were on the mental downward train last night because Jb was on the computer most of the night, watched a tiny bit of tv with me, then zonked out. I immediately started in with the whole, "He never wants to spend time with me anymore. He must not love me. The computer and tv are more important than me. This is just like my last relationship. I'm losing him. What if he cheats on me? He probably doesn't love me anymore. He probably hates me and thinks I'm crazy." Which he should when I think things like that. Because, you know, he couldn't possibly be tired because he's had a long week at work in 90 degree weather, which would be enough to sap anyone. So this becomes just another symptom to bring up to my psych doctor.

Also, I willfully didn't take my meds last night. I didn't want to. I didn't want to have to be taking meds, and certainly not so damn many. Most of the time, I'm extremely faithful to the idea of being med compliant. But last night, I was so down with the paranoid thinking that I didn't see how it mattered if I took meds or not. I didn't care. I didn't care about me.

On a better note, I did take my meds this morning. Lamictal and Wellbutrin down. As far as my sleep schedule, tried to go to bed around 10:30-ish. Not sure when I actually got to sleep. Slept until about 10:30-ish this morning. 12 hours. A little too long, maybe.

8:10 a.m. Meds Check

Saw the psych doctor on Monday, the day after the move. Told the psych nurse practitioner that I had been feeling depressed, wishing I were back in the hospital, thinking bad thoughts, but not to the point of having a plan. Just the beginnings of them. I was crying more, acting out and difficult to handle, and not interested in much, despite the obvious need to pack and move. I told her that I know change is a trigger for me, and that I usually go depressed afterward. I'm still sleeping a ton. So she tweaked my meds and actually put me on an antidepressant along with the sleep aid and mood stabilizer. Why I wasn't on one before this, I've no idea. There was also talk of raising my Lamictal because of the anger and irritability, but we never settled on a dosage.

Here's my new list of psych meds:
Wellbutrin XL 150 MG 1x a day (antidepressant)
Lamictal 100 MG 2x a day (mood stabilizer)
Remeron 30 MG 1x a day (sleep aid/sort of an antidepressant; up from 15 MG)
Klonopin 1 MG 2x a day (anti-anxiety)

Other meds:
Benicar HCT 40/25 MG 1x a day (blood pressure)
Protonix 40 MG 1x a day, as needed (gastro-intestinal pain)
Levsinex .375 TIMECP 2x a day (abdominal pain/IBS symptoms)

Add to that the 2 Tylenol or Ibuprofen I've been taking for my left knee (osteo-arthritis is acting up with all the rain and change of seasons), and I'm starting to feel like I need a day-of-the week pill box with separate day and night chambers. Not to mention that you'd think someone with Bipolar, IBS, GERDS, lymphadema, and osteo-arthritis could get a response on her medical assistance application from the county. It does hurt the morale.

And Moved. Thank God.

Been in the new place for, oh, a week now. So much to say about the week it took Comcast to decide we had an apartment, then set up our internet and cable, which, of course, didn't work without another call to Comcast. Hatred of monopolies aside, it's been a rough week. I didn't write anything at all this last week, even offline. I'll have to address some of what happened over the week, including a psych appointment and the tweaking of my med dosage tomorrow.

5:32 a.m. Lack of Sleep & Meds

Tried for an early night last night (10 p.m.), but I was up at 1 a.m., now again at 5:30 a.m. I'm not all that tired, considering I'm running on about 5 hours of sleep a night. I don't know if this is the Lamictal affecting my sleep, which it can, or evidence of a low hypomania because of the move.

On a bad note, I forgot to take my meds last night. I'd been doing so well, too, but I got caught up in watching Firefly (why Fox ever canceled it's one decent show, I'll never understand), among other things, and simply forgot. As for the sleeping, I think I may switch from taking 100MG x 2 tablets of Lamictal in the morning to 100MG in the morning and then another 100MG at night, which is how it was initially prescribed, though the psychiatric nurse practitioner told me to take 200MG in the morning if it messed with my sleep.

Somehow, it may be messing with my sleep in the wrong way. At the same time, they halved my Remeron to 15MG down from 30MG. Remeron's known to have a sedative effect. So it could be the Remeron moving out of my system. And while I was sleeping far too much before on the higher dose of Remeron, now I'm not sleeping enough. And sleep is part of the stabilization game. So many patients with mental health problems swear that they need 8 hours of sleep and a set schedule to keep themselves on the up-and-up.

Edit: According to Crazy Meds, "Another not-so-common effect [of Lamictal] is a type of insomnia where you're tired, but you can't sleep." Hm.

By the by, I've found Crazy Meds to be an excellent resource for looking up a medication's side effects, and often, I find the collection of patients' experiences with the medication a better indicator of side effects than what my psych doesn't tell me. On the other hand, I've been sore all week, but I've also been cleaning and packing a good deal, so I'm not going to attribute that to Lamictal right away. If it keeps up after the move, it may make me more thoughtful.

12:01 p.m. Pharmacies, Insurance, & Copayments, Oh My!

Thwarted at the pharmacy. I swear. Took a bus all the way out to the hospital, and I could only get the Lamictal filled. Luckily, it was the one I was completely out of. Since I seem to have dropped off prescriptions elsewhere, insurance won't pay for them until June 13th. Nevermind that my prescription has changed. But I've enough Remeron and Klonopin to last me a couple days more. I checked out my receipt for my Lamictal and about went into sticker shock. $20 with insurance. Without? $276. My god! I need to look up one of those free prescription programs my nurse practitioner (PCP) told me about. (This is when I seriously consider moving to Canada.) Health Insurance will certainly be a big influence on who gets my vote, that's for sure.

On another note, side effects today. I was falling asleep on the bus and in the pharmacy waiting room. And walking was this odd sort of seasick weave out to the bus stop and down the halls. My feet kept wanting to go in front of each other, and my body kept wanting to gravitate toward the nearest wall. It's a strange sort of gravity, this dizziness thing. And I feel weak, unable to really get to work and start cleaning the kitchen and the bathroom, both of which need it. I was also planning on making this Creamy Sausage Casserole with Biscuits, but that might be overkill for today. I hate having to conserve and space out my energy. I understand how, even when a patient might be feeling better, that person might still be unable to work. I do believe it'd be frowned upon if someone was found, head on their keyboard, at work. Not to mention the walking like you're drunk. Stellar review, I'm sure.

By the by, I love my nurse practitioner. She gave me two months worth of samples of Benicar so I wouldn't have to pay for them because she knew I'd lost my job. Psychiatrists, on the other hand, are stingy bastards I'm finding, and look at you like you're a junky if you ask for samples. Given the fact that they're the ones prescribing the medicine, it just makes me wanna slap 'em.

9:59 a.m. Morning

Crawled back into bed around 7 and slept until 9:59 a.m. I don't know if this is a good sign, or if it's merely the fact that the phone rang three different times waking me each time. I assume the latter, but I could be wrong. The credit card companies are beginning to call, circling like dogs, hoping to get blood from a stone.

And that's the problem with being mentally ill for a long period of time. You lose almost everything. This particular bout of depression started in June 2008 and was coupled with IBS (Irritable Bowel Syndrome), which made the whole thing twice as difficult. I'd have anxiety attacks on the way to work, I'd throw up outside the metro, I'd have to stop halfway to work to use the bathroom, I even had an "accident" once. Sometimes, I couldn't even leave the house. There's nothing more humbling and incapacitating than being unable to control your bodily functions. Then there was the depression on top of it, or wound up in it, and there were days the depression was so thick it was like struggling through deep water, and I couldn't leave the bed.

Soon enough, I had exhausted my Family Medical Leave, though my doctor supported my need to be out of work intermittently as I dealt with both the IBS and the depression. But work only has so much patience with these matters, and I could see the moment my boss and HR began to treat me as if I was a liar and lazy, instead of incredibly sick. My boss began withholding work from me, and my job satisfaction plummeted. So did my self-esteem. It was cyclic, and only fed the depression. Eventually, she took me down to HR to formally reprimand me for what she called "abuse of sick leave," the terms of which said I was not to miss work or be late for over a month. That effectively severed any ability for me to make follow-up appointments with my PCP or my psychiatrist. I was so overwrought at my loss of control, at how far the illness had taken me, and my inability to live up to my supervisor's expectations that I had my breakdown in the HR office. I went into the hospital that night. It took them nearly nine hours to admit me.

When the psychiatric intake social worker began asking me about how I felt, about whether I had suicidal ideation, if I had a plan, I had to ask Jb to leave the room. I didn't want him to know how far down I'd gone, how very lost I was, how out of control. It was after the Heath Ledger overdose, and overdose was foremost in mind. I remember her asking me, "Why?" And I remember replying, rather bitterly, "It worked for Heath Ledger, didn't it?" She said, chastised, "Yes, yes, it did." And I could tell she took me more seriously then. I admitted to thoughts about cutting, about knives and razors, and fantasies about my sleep apnea machine, my CPAP. I'd lie in bed at night, put my mask on, wait for that first rush of air, and pretend it was a sort of poison gas, an euthanasia of sorts, from which I wouldn't have to wake up ever again.

I was in the hospital for nearly a week, partly because I entered right before a weekend and they don't discharge patients over the weekend, and partly because for the first five days, I didn't even consider going home, much less ask if I could. Instead, I wandered from room to room: the day room, the activities room, my room, the dining room, back and forth, down the halls and back. I didn't speak for the whole first day, and then I couldn't stop crying. I was shaky and in shock. They'd taken me off all my meds, waiting for a diagnosis from the doctor and psychiatrist who made their rounds in the ward. Not everyone knows this, but even patients who go in voluntarily are put in a locked ward. You sign away the responsibility of your life for at least three days. After that, you can make a formal request to be discharged.

The hospitalization was my first, and while humbling beyond anything I'd experienced, it was also freeing -- to be in a place with people who understood, to know I wasn't alone, to know I wasn't even as bad off as some of the patients who'd been in the hospital again and again and again. Being depressed, having suicidal thoughts, it was normal in the ward, and something that us patients often talked about at night before snack and after our meds. Group therapy was a laugh, something I often left to go curl up in my bed, but those late night sessions with the other patients, those helped far more than anything else could have. I'd like to write more about the hospitalization, but I think that'll be another post. There's simply too much to tell.

Anyway, it was three months after the hospitalization that I could even begin to think about a future, and that's when my job forced me into a voluntary resignation. I'd already been on unpaid leave of absence, but without money for all that time, there was nothing to do but let the credit cards go, to batten down and focus on the necessities: food, rent, my meds. And all the while, Jb supported me, even when I lost everything, even when I took him down with me. Now we're on food stamps, the county has me on temporary disability and cash assistance, and that in itself is a coup, as I've found they'd rather not help you than help you.

I've lost my train of thought now, and so I'll end this post here. I know I'll have to write more about the hospitalization at some point, but I think it'll come in fits and starts. My writing is shoddy at best these days, but I am writing, and that consoles me. Still, as I start feeling better and better, I worry about the day when I'll have to retake a useful position in society. And a fear flutters somewhere near my heart, and my stomach clenches to think about it. So not quite yet. Not quite yet. But maybe soon. Sooner than I'm ready for. I can't help but think: What if I can't hack it? What if the anxiety, the IBS, the stomach pain, the depression all come back? I know I'll be nearly manic the first few months: overworking, proving myself, charismatic among the other employees, perfectly charming with the customers. But then there'll come that fall, like a fall from grace, and I don't know how many more times I can handle that.

It reminds me of the Yeats poem, "The Second Coming":

Things fall apart; the center cannot hold

It's lines like that my brain seizes on, repeating them like a morbid mantra, over and over: things fall apart; the center cannot hold; things fall apart; the center cannot hold; things fall apart; the center cannot hold; I fall apart; I cannot hold.